Mussels are well-known for their extraordinary capacity to adhere onto different surfaces in various hydrophillic conditions. Their unique adhesion ability under water or in wet conditions has generated considerable interest towards developing mussel inspired polymeric systems that can mimic the chemical mechanisms used by mussels for their adhesive properties. Catechols like 3,4-dihydroxy phenylalanine (DOPA) and their biochemical interactions have been largely implicated in mussels’ strong adhesion to various substrates and have been the centerpoint of research and development efforts towards creating superior tissue adhesives for surgical and tissue engineering applications. In this article, we review bioadhesion and adhesives from an engineering standpoint, specifically the requirements of a good tissue glue, the relevance that DOPA and other catechols have in tissue adhesion, current trends in mussel-inspired bioadhesives, strategies to develop mussel-inspired tissue glues, and perspectives for future development of these materials.

Mussel-inspired bioadhesives in healthcare: design parameters, current trends, and future perspectives.

The native cartilage extracellular matrix (ECM) is enriched in sulfated glycosaminoglycans with important roles in the signaling and phenotype of resident chondrocytes Recapitulating the key ECM components within engineered tissues through biomimicking strategies has potential to improve the regenerative capacity of encapsulated cells and lead to better clinical outcome Here, we developed a double-modified, biomimetic and tissue adhesive hydrogel for cartilage engineering We demonstrated sequential modification of alginate with first sulfate moieties to mimic the high glycosaminoglycan content of native cartilage and then tyramine moieties to allow in situ enzymatic crosslinking with tyrosinase under physiological conditions Tyrosinase-crosslinked alginate sulfate tyramine (ASTA) hydrogels showed strong adhesion to native cartilage tissue with higher bond strength compared to alginate tyramine (AlgTA) Both ASTA and AlgTA hydrogels supported the viability of encapsulated bovine chondrocytes and induced a strong increase in the expression of chondrogenic genes such as collagen 2, aggrecan and Sox9 Aggrecan and Sox9 gene expression of chondrocytes in ASTA hydrogels were significantly higher than those in AlgTA Chondrocytes in both ASTA and AlgTA hydrogels showed potent deposition of cartilage matrix components collagen 2 and aggrecan after 3 weeks of culture whereas a decreased collagen 1 deposition was observed in the sulfated hydrogels ASTA and AlgTA hydrogels with encapsulated human chondrocytes showed in vivo stability as well as cartilage matrix deposition upon subcutaneous implantation into mice for 4 weeks Our data is the first demonstration of a double-modified alginate with sulfation and tyramination that allows in situ enzymatic crosslinking, strong adhesion to native cartilage and chondrogenic re-differentiation

/pdf/tyrosinase-crosslinked-tissue-adhesive-and-biomimetic-1dk7iuu4a0.pdf

Tyrosinase-crosslinked, tissue adhesive and biomimetic alginate sulfate hydrogels for cartilage repair.

Object In recent years, dramatic changes in surgical education have increased interest in simulation-based training for complex surgical skills. This is particularly true for endoscopic third ventriculostomy (ETV), given the potential for serious intraoperative errors arising from surgical inexperience. However, prior to simulator development, a thorough assessment of training needs is essential to ensure development of educationally relevant platforms. The purpose of this study was to conduct a national needs assessment addressing specific goals of instruction, to guide development of simulation platforms, training curricula, and assessment metrics for ETV. Methods Canadian neurosurgeons performing ETV were invited to participate in a structured online questionnaire regarding the procedural steps for ETV, the frequency and significance of intraoperative errors committed while learning the technique, and simulation training modules of greatest potential educational benefit. Descriptive data analysis was c...

Needs assessment for simulation training in neuroendoscopy: a Canadian national survey.

Background All orthopaedic and trauma surgeons attend educational events throughout their careers. Many surgeons find that when they return to practice they are unable to put into effect those things that they have learned. Methods This study focussed on 708 surgeons from 2 different cultural backgrounds (developed and developing world) who attended 7 separate trauma Educational events. Surgeons were contacted by e-mail at least 6 weeks after the event and asked if they had encountered any Barriers, which had prevented them from putting into practice what they had learned at the event. If Barriers had been encountered they were asked to categorize them and state if they were able to overcome them. Results Barriers affect nearly every learner and learners are usually unable to overcome them. The study identified what barriers exist for implementation of acquired knowledge, how they vary with the degree of experience of the surgeon and his or her cultural background. Conclusion The commonest barrier amongst all surgeons is not having contact with a suitable patient to treat with their new knowledge and skills. Inability to get access to equipment and facilities is a major barrier for many surgeons especially in the developing world. This has profound implications for organizers of educational events that will need to incorporate strategies into their educational planning to help surgeon learners avoid or overcome barriers.

Barriers to orthopaedic practice--why surgeons do not put into practice what they have learned in educational events.

Orthopaedic surgeons traditionally have been trained with use of an apprenticeship model, with experience being measured on the basis of case log documentation and with competency being determined by senior mentors. Over the past decade, medical education has undergone a major paradigm shift, with increasing emphasis on teaching toward competence as a specialist, including operative skills, essential knowledge for practice, professionalism, and the use of evaluation methods thought to be credible, accurate, reproducible, and transparent. The primary use of an apprenticeship model may result in graduates never having performed some procedures or never having managed patients with certain diagnoses. Alternatively, the competency model may result in graduates performing well on certain standard procedures but perhaps not demonstrating competency on relatively rare entities. While the provision and assessment of medical education have become more complex in proportion to advanced technologies and novel procedures, delivering excellence in education itself has become increasingly difficult as a result of duty-hour restrictions, …

Orthopaedic Graduate Medical Education: A Changing Paradigm.

Modern surgical education is evolving with changes in the academic environment. Surgeons, surgical educators, and administrative associations need to know what to teach, how to do it, and whether it has succeeded. Whereas surgeons have many tools to help them to see what is needed for better patient care and to measure patient progress, surgical education is just beginning to develop techniques of interpreting the needs of students and to assess outcomes of learning in their practice1,2. The absence of surgical education assessment techniques has made it necessary to guess what is needed to improve education. We have estimated the success or failure of teaching by attempting to score faculty performance rather than on obtaining more valid data. This has led surgical educators to use mistaken assumptions based on their personal experience or reasoning without evidence3.

Surgical education should be based on needs assessment, efficient program planning, and a strong curriculum. The motivation of learners should be high, and the learners’ needs should be met. This is dependent on measurable outcomes with objective data demonstrating knowledge acquisition that meets the needs of surgical learners4.

In the last ten years, the providers of educational resources—governments, training boards, charitable foundations, and commercial companies—have been increasingly interested in whether surgical education, as it is delivered, has had a measurable effect5-7.

Through a series of pilot-tested steps, we developed a set of instruments, providing insights into the effectiveness of surgical education in the field of orthopaedic trauma. We termed the instrument the Learning Assessment Toolkit. It was developed to supplement the judgment of surgical educators before and after a teaching event with real evidence of need, motivation, and outcomes of educational programs in orthopaedic trauma surgery.

The primary goal of this report …

Learning assessment toolkit.

Topics in Training Learning Assessment Toolkit

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Learning assessment toolkit.

Topics in Training Learning Assessment Toolkit